Nokea
Quality management and benchmarking are two approaches used to improve the quality of care. The major difference between these two approaches is which of the following?
- A. Quality management is not useful in the outpatient setting
- B. Benchmarking compares outcomes in a variety of settings and disciplines
- C. Quality management is used only in the primary care setting
- D. Benchmarking looks only at outcomes specific to nursing
Correct Answer: B
Rationale: The correct answer is B: Benchmarking compares outcomes in a variety of settings and disciplines. Quality management focuses on establishing processes to ensure quality care within a specific setting, while benchmarking involves comparing performance metrics across different settings and disciplines to identify best practices and areas for improvement. Therefore, B is the correct answer as it highlights the key difference between quality management and benchmarking.
Incorrect answers:
A: Quality management can be useful in any healthcare setting, not limited to outpatient.
C: Quality management is applicable across various healthcare settings, not just primary care.
D: Benchmarking looks at outcomes in various areas, not just nursing.
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After discussing alternatives to dressing change procedures to minimize discomfort, the nursing staff accepted a new procedure. This is an example of which stage of Havelock's model of change?
- A. Moving
- B. Self-renewal
- C. Refreezing
- D. Unfreezing
Correct Answer: A
Rationale: The correct answer is A: Moving. In Havelock's model of change, the Moving stage involves implementing the chosen change after considering alternatives. In this scenario, the nursing staff accepted a new procedure, indicating they are moving forward with the change. This stage focuses on putting the change into action.
Summary of other choices:
B: Self-renewal - This choice is not applicable as self-renewal refers to personal growth and development, not organizational change stages.
C: Refreezing - This choice is incorrect as refreezing involves stabilizing the change and ensuring it becomes the new norm, which comes after the Moving stage.
D: Unfreezing - This choice is incorrect as unfreezing refers to preparing for change by overcoming resistance and creating readiness, which precedes the Moving stage.
What behaviors can be observed before a person becomes violent? (EXCEPT)
- A. Wandering
- B. Tense shoulders and clenched fists
- C. Blank stare
- D. Positioned with one foot in back and an arm pulled back
Correct Answer: A
Rationale: The correct answer is A because wandering is not typically associated with violent behavior. Tense shoulders and clenched fists (B), blank stare (C), and positioned with one foot in back and an arm pulled back (D) are commonly observed behaviors before a person becomes violent. Tense shoulders and clenched fists indicate agitation, a blank stare can indicate aggression, and the specific body positioning described in D suggests readiness for physical aggression. Wandering, however, is more likely to indicate confusion or aimlessness rather than impending violence.
Which of the following clients would most likely be selected for case management?
- A. An adolescent with a gunshot wound who is in the ER.
- B. A young adult with a fractured pelvis.
- C. An elderly client awaiting a hip replacement.
- D. A 41-year-old client admitted for outpatient tonsillectomy.
Correct Answer: C
Rationale: The correct answer is C because an elderly client awaiting a hip replacement typically requires ongoing support and coordination of services, making them a good candidate for case management. This client would benefit from assistance with navigating the healthcare system, coordinating appointments, and ensuring continuity of care post-surgery.
Choice A is incorrect as the adolescent with a gunshot wound in the ER is likely to be in need of immediate medical intervention rather than case management. Choice B is incorrect as a young adult with a fractured pelvis may require medical treatment but may not necessarily need the level of ongoing support that case management provides. Choice D is incorrect as a 41-year-old client admitted for an outpatient tonsillectomy is a relatively straightforward procedure that may not require extensive case management services.
One of the perceptions of turnover is:
- A. Poor management
- B. Rejection of the job
- C. Loss of poor performers
- D. Poor job atmosphere
Correct Answer: B
Rationale: The correct answer is B: Rejection of the job. Turnover can occur when employees feel dissatisfied with their job roles, responsibilities, or work environment, leading them to reject the job and seek opportunities elsewhere. This perception aligns with the concept of voluntary turnover, where employees choose to leave due to personal reasons rather than external factors like poor management (A), loss of poor performers (C), or poor job atmosphere (D). These other choices focus on external factors or outcomes of turnover, whereas choice B directly addresses the personal perspective of the employee as a key driver of turnover.
A diabetic patient who has reported burning foot pain at night receives a new prescription. Which information should the nurse teach the patient about amitriptyline (Elavil)?
- A. Amitriptyline decreases the depression caused by your foot pain.
- B. Amitriptyline helps prevent transmission of pain impulses to the brain.
- C. Amitriptyline corrects some of the blood vessel changes that cause pain.
- D. Amitriptyline improves sleep and reduces awareness of nighttime pain.
Correct Answer: B
Rationale: The correct answer is B because amitriptyline is a tricyclic antidepressant that works by inhibiting the reuptake of serotonin and norepinephrine, thus helping to prevent the transmission of pain impulses to the brain. This mechanism of action is effective in managing neuropathic pain, such as burning foot pain in diabetic patients. Choices A, C, and D are incorrect because amitriptyline's primary mechanism of action is related to its effects on neurotransmitter reuptake, not directly related to mood improvement, blood vessel changes, or sleep improvement.